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What support can Renassist provide for patients trying to access Hectorol® (doxercalciferol) injection and capsules?

  • Reimbursement support via prescription drug benefit verification
  • Prior authorizations facilitation
  • Renassist Patient Assistance Program (RPAP) information

What is RPAP?

RPAP is designed for patients in financial need who do not have coverage for Hectorol® (doxercalciferol) injection under any prescription drug benefit, including commercial insurance, Medicare, Medicaid, or other government insurance programs.

Through a partnership with the American Kidney Fund (AKF), Sanofi provides qualifying patients with medication at no cost.

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Indication
  • Hectorol (doxercalciferol) Injection is indicated for the treatment of secondary hyperparathyroidism in patients with chronic kidney disease on dialysis.
  • Hectorol capsules are indicated for the treatment of secondary hyperparathyroidism in patients with Stage 3 or Stage 4 chronic kidney disease not on dialysis and patients with chronic kidney disease on dialysis.

Important Safety Information
  • Hectorol is contraindicated in patients with a tendency towards hypercalcemia, or evidence of vitamin D toxicity
  • Hectorol injection is contraindicated in patients with previous hypersensitivity to doxercalciferol or any of its ingredients.
  • Overdosage of any form of vitamin D is dangerous and may lead to progressive hypercalcemia, which if severe, may require emergency attention.
  • Acute hypercalcemia may exacerbate tendencies for cardiac arrhythmias and seizures and may potentiate the action of digitalis drugs.
  • Chronic hypercalcemia can lead to generalized vascular and other soft tissue calcification.
  • Pharmacologic doses of vitamin D and its derivatives should be withheld during Hectorol treatment to avoid possible additive effects and hypercalcemia.
  • The patient should be informed about adherence to instructions about diet, calcium supplementation, and avoidance of the use of nonprescription drugs without prior physician approval. Patients should also be carefully informed about the symptoms of hypercalcemia such as weakness, headache, drowsiness, nausea, vomiting, dry mouth, constipation, muscle pain, bone pain, metallic taste and loss of appetite.
  • Uncontrolled serum phosphorus in patients undergoing dialysis may lessen the effectiveness of Hectorol.
  • Magnesium-containing antacids and Hectorol should not be administered concomitantly.
  • Serious hypersensitivity reactions, including fatal outcome, have been reported post marketing in patients on hemodialysis following administration of Hectorol Injection. Hypersensitivity reactions include anaphylaxis with symptoms of angioedema (involving face, lips, tongue and airways), hypotension, unresponsiveness, chest discomfort, shortness of breath, and cardiopulmonary arrest. These reactions may occur separately or together
  • Monitor patients receiving Hectorol Injection upon initiation of treatment for hypersensitivity reactions. Should a hypersensitivity reaction occur, discontinue Hectorol, monitor and treat if indicated
  • Patients should be checked and treated for nutritional vitamin D deficiency prior to initiating treatment with Hectorol capsules.
  • Cholestyramine may impair intestinal absorption of doxercalciferol capsules.
  • Enzyme inducers may affect the 25-hydroxylation of Hectorol and may necessitate dosage adjustments. Cytochrome P450 inhibitors may inhibit the 25-hydroxylation of Hectorol. Formation of the active Hectorol moiety may be hindered.
  • Adverse effects of Hectorol injection treatment are: hypercalcemia, hyperphosphatemia, and oversuppression of iPTH. Adverse effects of Hectorol capsules treatment are hypercalcemia, hyperphosphatemia, hypercalciuria, and oversuppression of PTH. These should be managed by regular patient monitoring and appropriate dosage adjustments.
  • Serum levels of iPTH, calcium and phosphorus should be determined prior to initiation of Hectorol treatment. During the early phase of treatment they should be determined weekly.
  • Adverse events reported by ≥5% of the Hectorol-treated dialysis patients included: edema, headache, malaise, nausea/vomiting, dizziness, dyspnea, pruritus and bradycardia.
  • Adverse events occurring at a frequency of ≥5% in patients taking Hectorol capsules with Stage 3 or Stage 4 chronic kidney disease not on dialysis were infection, chest pain, constipation, dyspepsia, anemia, dehydration, depression, hypertonia, insomnia, paresthesia, increased cough, dyspnea and rhinitis.
  • This drug should be used during pregnancy only if clearly needed.
  • Nursing mothers should discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother.
  • This drug should be used with caution in patients with impaired hepatic function.

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US.SEV.17.01.021 Last Updated: February 2017